Global variation in the quality of care for rheumatoid arthritis and associated factors

Although the quality of care related to rheumatoid arthritis (RA) has improved, ensuring high-quality care globally remains a significant challenge. To address this issue, we have introduced a modified Quality of Care Index (QCI) to evaluate variations in RA care services worldwide and analyze the influencing factors.

The QCI was derived from a principal component analysis of global incidence, mortality, and prognostic indicators of RA. Joinpoint regression and linear mixed models were employed to analyze the temporal trends of the QCI and its influencing factors.

In 2021, the global QCI for RA was 72.09. Among this, the QCI for males was 77.25, while for females it was 71.12. Based on Joinpoint regression, the AAPC of the global RA QCI from 1990 to 2021 was 0.30(0.29-0.31), with 0.22(0.20-0.23) for males and 0.29(0.28-0.30) for females. Based on the LMM model, it was found that age, gender, year, and SDI were all statistically significantly associated with QCI (p < 0.05). Specifically, positive correlations with QCI were observed in the following groups: under 14 years, 20-24 years, 40-54 years, 70-74 years, males, and high-SDI regions. Conversely, negative correlations with QCI were identified in the age groups 15-19 years, 25-39 years, 55-69 years, and 75 years and above.

Disparities in RA-related care exist across gender, age, and geographic regions. Further emphasis should be placed on improving care for female RA patients and those in low-SDI regions.